Well, you gain pleasure from different things depending on sado and maso levels. High sado gives pleasure when you attack enemies and high maso when they attack you.
I'm not sure if there are actually different dialogues or scene differences with the high sado or maso since I haven't done a really high run of either in the last couple of updates, and the heart eyes and inviting the previous poster mentioned may just be high slutty.
Receiving erotic pleasure while fighting is just as goofy as granting sadistic passives to Karryn for initiatiing titjobs or pussy-sex. I wish the devs stopped this nonsense, which seriously distorts the concept of BDSM.
Textual and graphic variations are the main means of expression of Karryn's sexuality and that's how the game works. There is only a limited number of scenes and poses, which simply change here and there depending on MCs levels of sluttery, sadism/masochism, desires/, sensitivies, resistance and so on. A newbie Karryn threatens the Guards with eye gouging just because they looked at her, while a slutty Karryn with low sight resistance is capable of cumming just from being looked at. And she'll say 'How do you like my perfect fat ass?' to people ogling her butt for example. Without these texts it would be hard to notice any progress in her depravation and thus enjoy playing the game.